The gist

The bill funds new Health Savings Accounts (HSAs) for Affordable Care Act (ACA) marketplace shoppers, while cutting federal coverage for gender transition care and undocumented immigrants.

Who wins, who loses

• Wins: middle-income adults buying bronze or catastrophic ACA plans; states that verify immigration status strictly.
• Loses: transgender patients seeking covered care; undocumented immigrants; states funding healthcare for non-citizens.

What it does

• Deposits $1,000/year (ages 18-49) or $1,500/year (ages 50-64) into HSAs for bronze/catastrophic plan enrollees earning up to 700% of poverty.
• Appropriates $10 billion yearly for 2026 and 2027 to fund the HSA deposits.
• Bars ACA plans from covering abortion or gender transition procedures as essential benefits starting 2027.
• Cuts federal Medicaid match to 80% for states covering undocumented immigrants.

Why should I care?

Supporters say the HSA payments give patients more control over healthcare spending and lower premiums for younger buyers. Critics argue the bill strips coverage from transgender people, including minors on puberty blockers, and punishes states helping immigrants. The abortion and gender care restrictions affect teens directly through family plans. Where do you land? Vote below and use "Tell Your Rep" to make sure your voice reaches Congress.